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Abstrak :
[ABSTRAK
Pendahuluan: Osteopontin merupakan salah satu penanda molekuler hipoksia endogen tumor. Hipoksia adalah salah satu faktor yang menentukan agresifitas penyakit. Kadar osteopontin tinggi pada berbagai keganasan termasuk glioma maligna. Peningkatan kadar osteopontin akan menyebabkan respon terapi berkurang. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar osteopontin praradiasi dengan respon radiasi pada glioma maligna. Metode: Penelitian ini merupakan studi retrospektif kohort terhadap 15 pasien maligna glioma yang menjalani terapi radiasi dari juli 2004 sampai mei 2015 di RSUPN. DR. Cipto Mangunkusumo. Osteopontin diperiksa menggunakan metode ELISA dari sampel parafin blok. Volume tumor dihitung dari CT scan atau MRI berdasarkan pengukuran volume tiga dimensi. Respon tumor dinilai dengan membandingkan volume tumor sebelum dan sesudah radiasi dengan menggunakan CT dan MRI. Hasil: Didapatkan rerata kadar osteopontin sebesar 0,49 ± 0,45 ng/ml, rerata persentase perubahan volume tumor 8,59 ± 54,22 %. Volume tumor yang membesar 60%. Tumor yang progresif sebesar 26,7%. Secara keseluruhan terdapat korelasi negatif lemah yang tidak bermakna ( r -0,39 dan p 0,146 ) antara kadar osteopontin dengan respon radiasi. Terdapat korelasi positif kuat yang tidak bermakna ( r +0,68 dan p 0,219 ) antara kadar osteopontin dengan respon radiasi pada kelompok yang menggunakan kemosensitizer temozolamide. Kesimpulan: Terdapat korelasi negatif lemah yang tidak bermakna antara kadar osteopontin dengan respon radiasi. Terdapat korelasi positif kuat yang tidak bermakna antara kadar osteopontin dengan respon radiasi pada kelompok yang menggunakan kemosensitizer temozolamide.

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ABSTRACT
Introduction : Osteopontin is an endogenous molecular marker of tumor hypoxia, which is one of factors that determine the aggressiveness of the disease. Increased level of osteopontin will decrease therapeutic response which will eventually influence the success of therapy.The purpose of this study is to determine the correlation between osteopontin level and radiation response in malignant glioma. Method : This is a retrospective cohort study of 15 malignant glioma patients who underwent radiation from July 2004 to May 2015 at Cipto Mangunkusumo Hospital. Osteopontin level was measured with ELISA from paraffin embedded tissue. Tumor volume was calculated by measuring three dimensional volume of tumor imaging from CT or MRI. Tumor response was evaluated by comparing pre-irradiation with post-irradiation tumor volume seen in CT and MRI. Result : The mean osteopontin level was 0.49 ± 0.45 ng/ml and the mean percentage of change in tumor volume was 8.59 ± 54.22 %. Enlargement of tumor volume was 60 %. Progressive disease was found in 26.7 % of patients. Overall, there was an insignificant weak negative correlation (r -0.39 and p 0.146) between level of osteopontin and radiation response. There was an insignificant strong positive correlation (r +0.68 and p 0.219) between level of osteopontin and radiation response in the group that received radiation therapy concurrent with temozolamide. Conclusion : Overall, there was an insignificant weak negative correlation between level of osteopontin and radiation response. In the group that received radiation therapy concurrent with temozolamide, there was an insignificant strong positive correlation between level of osteopontin and radiation response, Introduction : Osteopontin is an endogenous molecular marker of tumor hypoxia, which is one of factors that determine the aggressiveness of the disease. Increased level of osteopontin will decrease therapeutic response which will eventually influence the success of therapy.The purpose of this study is to determine the correlation between osteopontin level and radiation response in malignant glioma. Method : This is a retrospective cohort study of 15 malignant glioma patients who underwent radiation from July 2004 to May 2015 at Cipto Mangunkusumo Hospital. Osteopontin level was measured with ELISA from paraffin embedded tissue. Tumor volume was calculated by measuring three dimensional volume of tumor imaging from CT or MRI. Tumor response was evaluated by comparing pre-irradiation with post-irradiation tumor volume seen in CT and MRI. Result : The mean osteopontin level was 0.49 ± 0.45 ng/ml and the mean percentage of change in tumor volume was 8.59 ± 54.22 %. Enlargement of tumor volume was 60 %. Progressive disease was found in 26.7 % of patients. Overall, there was an insignificant weak negative correlation (r -0.39 and p 0.146) between level of osteopontin and radiation response. There was an insignificant strong positive correlation (r +0.68 and p 0.219) between level of osteopontin and radiation response in the group that received radiation therapy concurrent with temozolamide. Conclusion : Overall, there was an insignificant weak negative correlation between level of osteopontin and radiation response. In the group that received radiation therapy concurrent with temozolamide, there was an insignificant strong positive correlation between level of osteopontin and radiation response]

Abstrak :
Latar Belakang: Perawatan yang telah ada selama ini tidak memberikan hasil yang maksimal pada defek besar sehingga berkembang konsep rekayasa jaringan yang memiliki komponen scaffold, signaling molecule, dan sel. Scaffold yang digunakan adalah chitosan karena karakteristiknya yang biokompatibel dan biodgradable. RGD ditambahkan sebagai signaling molecule, yang berfungsi berperan untuk merangsang sel berdiferensiasi dan memproduksi matriks untuk perkembangan sel dalam membentuk jaringan. Tujuan: Mengetahui ekspresi protein OPN sebagai indikator regenerasi jaringan periodontal setelah pemberian bahan regeneratif. Metode dan Bahan: Model defek tulang horizontal pada tulang alveolar di sekitar gigi insisif lateral M.nemestrina yang dipaparkan bahan regeneratif chitosan atau RGD modified chitosan. 4 minggu setelah pemaparan bahan regeneratif jaringan dibiopsi dan diproses dengan metode IHK dengan antibodi OPN yang menandakan regenerasi jaringan periodontal, dianalisis melalui % area pewarnaan dan intensitas warna dengan metode grid pada aplikasi ImageJ. Hasil: Tidak ada perbedaan bermakna secara statistik antara kelompok chitosan dengan median % area pewarnaan positif 21,81 yang lebih tinggi dibanding RGD modified chitosan dengan median % area pewarnaan positif 10,88. Kesimpulan: Terapi regeneratif dengan pemberian chitosan atau RGD modified chitosan berpotensi meregenerasi jaringan periodontal. Penambahan RGD pada chitosan dievaluasi secara histologis tidak mempengaruhi ekspresi OPN. ......Background: Treatment that has existed so far doesn’t provide maximum results in large defects, so develops concept of tissue engineering that have scaffold, signaling molecule, and cell as components. The scaffold material used is chitosan because of its charactheristics which have high viscocity, the ability to bind to water, biocompatible, and biodgradable. RGD is added as a signaling molecule, which act to stimulate cells to differentiate and produce matrices for cell development in forming tissue. Objective: To know expression of OPN as periodontal tissue regeneration indicator after exposure with regenerative materials. Methods and Materials: The horizontal bone defect model in the M.nemestrina’s alveolar bone around lateral insisive was exposed by chitosan or RGD modified chitosan and biopsied after 4 weeks. Slides were processed through IHC method with OPN as antibody. The expression of OPN signifies periodontal tissue regeneration, analized through % area of staining and color intensity with grid method on ImageJ. Result: There was no significant difference stastically between chitosan with % positive staining area median 21.81 which was higher than RGD modified chitosan with % positive staining area median 10.88. Conclusion: Regenertive theraphy with chitosan or RGD modified chitosan potentially regenerate the periodontal tissue. Addition of RGD to chitosan evaluate histologically didn’t affect the expression of OPN.

Abstrak :
Latar Belakang: Terapi regeneratif jaringan periodontal pada kasus kerusakan tulang alveolar horizontal telah dilaporkan dapat meningkatkan perlekatan jaringan periodontal secara klinis. Tetapi, efek perawatan pada sintesis matriks ekstraseluler tulang belum diketahui. Osteopontin merupakan salah satu marker penanda tulang sehingga dapat digunakan dalam menganalisis keberhasilan regenerasi jaringan periodontal pascaterapi regeneratif. Tujuan: Menganalisis ekspresi osteopontin pascaterapi regeneratif PDL cell sheet + RGD-modified chitosan dan PDL cell sheet + chitosan scaffold terhadap regenerasi jaringan periodontal. Metode dan Bahan: Sampel penelitian adalah sediaan mikroskopik jaringan periodontal M.nemestrina yang telah ditanam bahan regeneratif PDL cell sheet + RGD-modified chitosan dan PDL cell sheet + chitosan scaffold selama empat minggu setelah perawatan. Sediaan diwarnai dengan metode imunohistokimia menggunakan antibodi osteopontin. Ekspresi osteopontin dianalisis area dan intensitas pewarnaannya dengan metode grid pada ImageJ, serta uji statistik menggunakan SPSS. Hasil: Median area pewarnaan positif pada PDL cell sheet + RGD-modified chitosan 74,81% (53,48%-81,06%) lebih besar dari PDL cell sheet + chitosan scaffold 63,99% (52,43%-80,31%), namun tidak berbeda bermakna secara statistik pada kedua bahan tersebut (p >0,05). Median intensitas area pewarnaan positif lemah 43,05% (14,16%-61,52%), sedang 14,49% (6,70%-22,81%), dan kuat 17,82% (3,66%-20,20%) pada kelompok PDL cell sheet + RGD-modified chitosan lebih besar dibanding PDL cell sheet + chitosan scaffold, namun tidak berbeda bermakna secara statistik. Kesimpulan: Ekspresi osteopontin lebih tinggi pada kelompok PDL cell sheet + RGD-modified chitosan dibanding kelompok PDL cell sheet + chitosan scaffold, meskipun kedua bahan tersebut tidak menunjukkan perbedaan bermakna secara statistik. ......Background: Periodontal regenerative therapy in bone horizontal defect cases has been reported to increase clinical periodontal tissue attachment. However, the outcome treatment on the synthesis of bone extracellular matrix is unknown. Osteopontin is one of the bone markers that can be used in analyzing the effectiveness regeneration after periodontal regenerative therapy. Objectives: To analyse osteopontin expression after periodontal regenerative therapy with PDL cell sheet + RGD-modified chitosan and PDL cell sheet + chitosan scaffold. Methods and Materials: Specimen was used from M.nemestrina periodontal tissue that had been planted for four weeks after regenerative therapy with PDL cell sheet + RGD-modified chitosan and PDL cell sheet + chitosan scaffold. Results: Median value of positive staining area in PDL cell sheet + RGD-modified chitosan with 74.81% (53.48%-81.06%) is greater than in PDL cell sheet + chitosan scaffold with 63.99% (52.43%-80.31%), and the two groups statistically showed no significant differences. Median value of positive staining intensity in weak area 43.05% (14.16%-61.52%), moderate 14.49% (6.70%-22.81%), and strong 17.82% (3.66%-20.20%) in PDL cell sheet + RGD-modified chitosan is greater than PDL cell sheet + chitosan scaffold, but there were no significant differences between the two groups. Conclusion: Regenerative therapy with PDL cell sheet + RGD-modified chitosan increased osteopontin expression higher than PDL cell sheet + chitosan scaffold, even though there were no significant differences between the two groups.